APPLICANT'S ABSTRACT: The aims of this Developmental Grant Proposal for Collaborative International Projects are to: 1) analyze the prevalence of alcohol-related emergency room (ER) visits in Poland; 2) examine the association of drinking patterns and alcohol- related problems with ER admission for an injury, including the role of alcohol in the injury event; 3) examine the association of demographic and drinking characteristics with ER services utilization among both injured and non-injured patients; 4) test the performance of short screening instruments (CAGE, RAPS and AUDIT) for identifying harmful drinking/abuse and alcohol dependence; 5) compare ER findings from Poland with similar ER data collected in the U.S. The proposed project will be the first to obtain data on alcohol and injury in probability samples of emergency room patients in an Eastern European country, where both alcohol consumption and the health care system have been undergoing enormous change. While the prevalence of heavy and problem drinking and rates of alcohol dependence are thought to be high in Poland, along with other Eastern European countries, the data are limited and the prevalence of heavy and problem drinking in ER caseloads, or among injuries, is relatively unknown. Data will be collected in two large public hospital ERs in Warsaw and Sosnowiec, which represent two diverse regions of the country. A probability sample of 1,722 patients will be breathalysed and interviewed at the time of the ER visit regarding drinking prior to the event and related variables, usual drinking patterns and alcohol-related problems including alcohol use disorders, and ER services utilization. A similar questionnaire will be used to that previously used in a number of studies in the U.S. and other countries for cross-national comparisons. The proposed project is important in determining the extent and nature of problem drinking in ER populations in a country which has undergone radical changes in both health services delivery and alcohol consumption, the burden of alcohol in ER caseload, and the potential of the ER as an important site for identifying those who could benefit from a brief intervention. Additionally, data from this project will also become an integral part of a comparative cross-national ER analysis of alcohol and casualty, under separate funding, and will be the only Eastern European contribution to this project in which similar methodology and scientific rigor was used, in 30 ERs across six countries (U.S., Canada, Mexico, Australia, Italy, Spain), and which will be the first such analytic under taking to examine the effect of organizational and sociocultural variables which influence the alcohol-injury nexus, and the interaction of these contextual variables with individual and event level variables.